Should You Get A Mammogram?

The short answer is NO! Absolutely not! A woman ages about 4 years every time she gets a mammogram. Radiation causes cellular damage associated with aging and DNA mutations that raise the risk of developing cancer. The more mammograms you get the greater the risk. Women who start getting annual mammograms at age 40 have a 12-14% increased risk of developing breast cancer by the time they turn 50. Mounting evidence now indicates that the any possible benefits of annual screening mammography are not worth the risk.
In 1992 the Canadian National Breast Screening Study found that women in their 40s are actually more likely to die of breast cancer after they receive a decade of annual mammograms than women who do not start getting mammograms until after age 50. In September 2001, a British study by Dr. Gavin T. Royle and colleagues from the Southampton Breast Unit reported that doctors beat mammograms at detecting breast lumps without inflicting cancer-causing radiation into your breasts. The Southampton Breast Unit found that mammography was up to one-third less likely to detect lumps than were physicians. There should be no more debate. Mammography is a serious cancer liability. It should be called what it is: “Harmful and Obsolete.”
The mammography controversy picked up significantly in October 2001 when the World’s leading medical journal, The Lancet, published a paper that clashed with the conventional thinking. The Lancet paper concluded that mammography did not help save the lives of breast cancer sufferers and that previous mammography studies showing the benefits of mammography had been seriously flawed.
In October 2004, two new studies found that MRIs are more accurate than mammograms for detecting early breast cancer. A Canadian study reported in the Journal of the American Medical Association
(JAMA 2004/292[11]:1317-25) concluded that MRIs were more sensitive and more specific in detecting small breast cancers than mammograms, ultrasounds or clinical breast exams. The second study found that screening by MRI detected 79.5% of invasive breast cancer, compared toonly 33.3% by mammography and 17.9% for clinical breast exam.
(NEJM 2004; 351: 427-37)
So why is it that the American Medical Association, the National Cancer Institute, the Health and Human Services Department and the U.S. Preventive Task Force all recommended that women in their 40’s should get mammograms every one to two years and women over age 50 should get them annually?
In my 20 years of medical practice, I have watched the recommendations change several times. A decade and a half ago mammograms were recommended only for women after age 50 and then only every 3 years. In the mind of the conventional medical establishment, mammography is now considered “preventive care.” They have believed the hypothesis that early detection of small breast lumps allows them to intervene earlier with surgery, chemotherapy and more radiation to saves lives.
Since the recommendation that women start getting mammograms beginning in their 40s, the American Cancer Society has reported that 18% of all new breast cancer cases in the U.S. occur among women in their 40s. In 1999, the American Medical Association (AMA) cited these figures to justify its reason for recommending that all 40-year-old women begin getting mammograms every year rather than every other year.
Could it be that more 40 year olds are getting breast cancer because more of them are getting mammograms more often? Is it possible that the AmericanCollege of Radiologists is finding more breast tumors in younger women because they are causing them with the radiation from annual mammograms?
The world’s largest study of routine mammograms including 50,430 women aged 40-49, conducted at 15 hospitals across Canada from 1980-1990, found that women who got annual mammograms had 22% more breast cancer than the women who did self breast exams rather than get annual mammograms.The mammogram group had twice as many cases of cancer metastasis, than the non-mammogram group and 36% more breast cancer deaths. (Canadian Med Assoc Journal 1992 Nov 15;147(10):1459-76)
This study should have ended the debate, however, old practices die hard. The controversy is a simple one. Mammography is a $5 billion dollar industry. It has to be justified to be continued. With best intentions doctors have assumed for decades that X-Rays, being able to detect small tumors in breasts before they could be found by physical exam, would save lives by early diagnosis, which would lead to early intervention. They do not want to admit that they may be wrong.
Several studies in women over age 50 have shown that mammography screening vs getting no annual physical breast exam, reduces the risk of dying from breast cancer by 5-33% depending on the age a woman begins getting mammograms. In a long-term Swedish study, the reduction was 5% in women aged 50-54 years and a 33% reduction in women aged 60-69 years at entry. (Lancet 2002 Mar 16;359(9310):909-19)
The problem with these studies is that they have compared mammograms vs doing nothing, rather than comparing mammograms to physical breast exams with a trained physician. The Canadian National Breast Screening Study:2 (NBSS-2 Study), however, did it right. It compared the efficacy of annual mammography plus physical examination of the breasts to physical examination of the breasts alone in reducing the rate of death from breast cancer among 39,405 women aged 50 to 59.
By the end of the NBSS-2 Study, 693 cases of breast cancers were found in the mammography plus physical examination group, compared to 626 cases in the physical examination-only group. At a 13-year follow-up, a similar number of deaths from breast cancer had occurred (107 and 105) in the respective groups. The authors concluded, “In women aged 50-59 years, the addition of annual mammography screening to physical examination has no impact on breast cancer mortality.” (J Natl Cancer Inst 2000 Sep 20;92(18):1490-9). In other words, there was no reduction in the death rate by getting a mammogram if a woman had already passed a physical examination by a trained physician.
The truth is there is no reliable evidence that having regular mammograms reduces the risk of dying of breast cancer in women of any age. In fact, there is strong evidence to the contrary. According to the Nordic Cochrane Center, in Copenhagen, a respected international body that assesses medical evidence, an analysis that examined seven completed and eligible trials involving half a million women found that “The currently available reliable evidence does not show a survival benefit of mass screening for breast cancer.”(Lancet 2001 Oct 20;358(9290):1340-2).
Why has this issue become so clouded and controversial? Why have these studies been ignored and criticized? Could it be that the conventional medical establishment has a too much vested interest in mammography, or too great a legal liability at stake to admit the obvious: Annual mammography, which admittedly causes significant side-effects, including cancer inducing radiation, and false-positives that lead to untold physical, emotional and financial stress, is no more effective than a good old-fashioned physical exam of the breasts.
Doctors Beat mammograms at Detecting Breast Lumps
Dr. Gavin T. Royle and colleagues group from the Southampton Breast Unit studied diagnostic data for 350 women with suspected breast cancer. They found that General practitioners (GPs) successfully identified lumps in 78% of cases, while breast surgeons were found to be slightly better with an 82% success rate. Mammography only proved sensitive in 63% of patients. “Both GP and breast surgeon clinical examination were more sensitive than mammography in determining if a lump was present,” Royle told conference participants. The study also found that ultrasound, which emits no radiation, was the best noninvasive way of determining whether lumps were benign or malignant.(Eur J Cancer 2001 Sep;37 Suppl 5:1-48)
Radiation Risks
“A woman can’t help noticing when the X-ray technician dashes for shelter behind a leaden window, before flicking on the X-Ray machine, that there must be significant risk of radiation from the test,” says Susan Brenner, director of the Breast Cancer Action group. It seems ironic to her that the technology the government regards as a lifesaving device uses ionizing radiation, which in high enough doses, is a well-established cause of breast cancer.
In most of the cancer literature, radiation is conveyed as an almost negligible concern. The National Cancer Institute guidelines state, “A final potential concern about mammography is radiation-induced breast cancer, but there are few data to directly assess this risk.”

”Now that the benefits of mammography have begun to be cast in greater doubt,” says Cindy Pearson of the National Women’s Health Network, in Washington, D.C., “those risks may also need to be better defined. Is there a level below which it is reasonably safe? They’ve never answered this question,” she says.

That’s because scientists have never been able to show what an absolutely safe dose is, says Barry Kramer, senior medical scientist in the cancer prevention division at the National Cancer Institute. “There is no doubt that X-rays cause cancer; it all boils down to your dose.”
Dr. Samuel Epstein, a professor of environmental medicine at the University of Illinois at Chicago School of Public Health, argues that the radiation risks of mammography are notoriously underestimated.

To help protect women, the Food and Drug Administration limits the amount of radiation that X-rays can deliver to women’s breasts to 300 millirems (a unit for measuring absorbed doses of radiation) per film per view, says Kramer. Even with that restriction, Epstein says, women receive too much radiation. Radiologists routinely take two films per breast.
To put this in perspective, says Mary Helen Barcellos-Hoff, a radiation biologist at Lawrence Berkeley Laboratories in San Francisco, the average American gets about 360 millirems of radiation annually, from natural background radiation coming from rocks, radon and cosmic rays, as well as man-made sources.” One stroll through an airport scanner causes 2 millirems of radiation exposure, a cross-country airplane trip will cause 5 millirems, a full dental X-ray causes 350 millirems, and a full body CT Scan can produce 6000 millirems.

A woman ages about 4 years every time she gets a mammogram

Contrary to conventional assurances, the radiation exposure of Mammography is certainly not trivial. The routine practice of taking two films for each breast amounts to about 600 millirems focused directly on each breast and 1200 millirems total. That is equivalent to the radiation exposure of 4 years of natural background exposure. In other words, a woman ages about 4 years every time she gets a mammogram.
Reporting in the International Journal of Health Services, Epstein and coauthors Rosalie Bertell and Barbara Seaman argue that the premenopausal breast is particularly sensitive to radiation. They estimate that every 1000 millirems of radiation exposure increases the risk of breast cancer by 1 percent. Therefore, women who start getting annual mammograms at age 40 would have a 12% increased risk of developing breast cancer due to the screening procedure by the time they turn 50. That does not sound like preventive care to me.

In Dr. Epstein’s opinion, the bottom line is this: “In healthy women, the risks of undergoing routine mammograms to screen for breast cancer outweigh the benefits.”
David Brenner, professor of radiation oncology and public health at ColumbiaUniversity, says that younger women have more cells that are actively dividing, making them even more vulnerable to radiation’s effects than women over the age of 50. Additionally, Mammograms are less reliable in younger women because of their denser breast tissue.

The National Cancer Institute estimates that annual mammography of 100,000 women for 10 consecutive years beginning at age 40 would result in up to eight radiation-induced breast cancer deaths. But Brenner’s studies, subjecting rodent cells to mammogram-level radiation, show that this estimate may be off by a factor of two.

While the risk of getting cancer from a mammogram is extremely low for the individual woman, Brenner says, it becomes a complicated public health question. He points out that currently some 30 million to 40 million women each year get mammograms. According to his calculations, given these theoretical models, mammography is likely responsible for 4,800 to 6,400 radiation induced cancers every year.
The fear of cancer and the prominent proponents of mammography are perhaps themselves the instigators of an epidemic of breast cancer induced by the so-called “preventive measure” itself. According to a Center for Disease Control report, “the percentage of women aged 40 and over who reported having a mammogram increased from 64% in 1989 to 85% in 1997.”
Officially the American Medical Association and the American Cancer Society both recommend that all women 40 and over get an annual mammogram, the National Cancer Institute, the Health and Human Services Department and the U.S. Preventive Task Force recommend that all women age 40 to 49 get mammograms every one or two years and women over age 50 get them annually.
The Hansen Clinic of Natural Medicine Recommendation
The Hansen Clinic of Natural Medicine recommends that a woman not get a mammogram ever.Dr Hansen simply says, “Stay behind the leaden glass window with the radiology tech anytime an X-Ray machine goes off. The radiation could kill you.”
Instead of an annual mammogram get an annual breast exam from your family doctor. If he or she finds a suspicious lump, then you should get an Ultrasound, which is the best non-invasive way to determine if the lump is hollow or solid tumor. If it is hollow it is a cyst and you need no further testing. If it is solid then you need an MRI.